Provider Demographics
NPI:1497455133
Name:AF RECOVERY PROCESS
Entity Type:Organization
Organization Name:AF RECOVERY PROCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:FIDALGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-409-9590
Mailing Address - Street 1:5 PLANTATION ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4964
Mailing Address - Country:US
Mailing Address - Phone:813-409-9590
Mailing Address - Fax:508-453-0287
Practice Address - Street 1:5 PLANTATION ST APT 1
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4964
Practice Address - Country:US
Practice Address - Phone:813-409-9590
Practice Address - Fax:508-453-0287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care